eHealthFiles PMS provides easy and user friendly interfaces to create and maintain patient accounts, generate super bills, submit claims and provides various other financial reports and statistics. The financial data is presented in an intuitive manner to both clinicians and office managers.

eHealthFiles has direct interface with major payers like Blue Cross & Blue Shield and Medicare, for sending claims, tracking remittances and audit trails. eHealthFiles also has an interface with a nationwide Clearing House for sending claims and receiving remittances for all other insurance companies. All the electronic transactions done through eHealthFiles are HIPAA Complaint.

The PMS includes electronic scheduling, billing, claims submission, electronic remittance and posting.

• Patient Archives & Demographics
• Scheduler
• Appointments Reminder Tracker
• Generating Super Bills
• HIPAA Complaint Interfaces with Blue Cross Blue Shied, Medicare and a Clearing House
• Automatic electronic reconciliation of remittances received from Insurance Companies
• Insurance Eligibility Validation
• Maintains patient accounting
• Various Financial Reports & Aging Reports

eHealthFiles enables physicians to customize Superbill for the respective Specialization services provided to the patient. It ensures that the bills are raised for all services provided to patients including the respective administrative charges, and they get cleared.

eHealthFiles effectively handles change in a patient’s Insurance coverage. It easily maintains the balance and the parties responsible for the balance. Patients Insurance information is stored with each claim and claims are routed to appropriate insurance companies. These Insurance claims can be validated for the completion before submission to the payer, and can be submitted electronically or printed immediately on HCFA forms.

Adjustments and accounting entries are posted to Patient Accounts, remarkably reducing complexity and increasing accuracy. Charges, payments and adjustment entries are immediately recorded in the system. The PMS helps in retrieval of the Electronic Remittance Advice (ERA) from the insurance carrier and posts the Explanation Of Benefits (EOB) directly to patient accounts for claims submitted electronically.

The system tracks continuously for the approved payment amounts received from insurance carriers for the various CPT codes and generates automated reminders to alert patients about the bills due.

Various Financial Reports & Aging Reports are also maintained.

The PMS operates in compliance with HIPAA 1996. Some of the HIPAA standards used are:

• Health Care Claim: Professional (837 - 004010X098)
• Remittance Advice (835 - 004010X091)